Atresia of the Abdominal Aorta Presenting as Neonatal Arterial Hypertension: a Case Report with Literature Review

Abstract

Objective − We present a case of neonatal arterial hypertension in a patient with atresia of the abdominal aorta diagnosed after an extensive diagnostic workup, emphasizing the importance of imaging methods in the detection of vascular malformations. The article reviews the vascular causes of neonatal arterial hypertension.

Case Report − A case of a 5-day-old boy born after 38 weeks of gestation who was admitted to a tertiary level medical center due to arterial hypertension, tachypnea, and a heart murmur was reported. Abdominal Doppler US revealed high flow paraspinal vessels and huge bilateral subcutaneous collaterals extending from the pelvis towards the upper abdomen. Common iliac arteries and abdominal aorta at the level of renal arteries and below could not be differentiated. The main differential diagnostic options were stenosis of the abdominal aorta or paraspinal arterio-venous malformation. Magnetic resonance angiography revealed atresia of the abdominal aorta, with large caliber bilateral paraspinal collaterals, feeding the lower part of the body. Surgical treatment wasn’t indicated at that time. At the present the patient is four years old, developing normally on antihypertensive therapy.

Conclusion − Neonatal arterial hypertension is rarely idiopathic, thus identifying a possible underlying illness becomes imperative. Imaging methods have a pivotal role in the early detection of the causes of neonatal arterial hypertension.